| NPI | 1396035143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: PA OS-017085) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34011357) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 34011357) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2023-02-09 |